Understanding the social factors that influence the translation of genetic information to improved human health is a major objective of genomics research (Grand Challenges II-5,II-6 and III-1). One current approach for applying genomics to public health is to raise social awareness of family history as an independent, major risk factor for common diseases of adulthood in order to motivate appropriate preventive actions. This research will evaluate whether such public health measures translate into long-term health benefits for individuals having strong genomic predisposition to coronary heart disease (CHD). The Pawtucket Heart Health Program (PHHP) was a community-based intervention that substantially and specifically raised community awareness about familial predisposition to CHD. We propose to conduct a controlled epidemiologic study in order to evaluate whether this community-level awareness of family history translates into a survival advantage for adults having a strong genomic predisposition to CHD. We hypothesize that adults with a 1st degree family history of early-onset CHD who live in the community enriched with awareness about familial predisposition to CHD will survive longer than those from the control community. Using PHHP household interview records accrued between 1989 and 1992, baseline serologic and physical exam data and National Death Index follow-up data, we propose to conduct a15-year longitudinal survival study (n=696) as the empirical basis for addressing our main hypothesis. Results from this study will provide timely empirical data regarding the potential impact that raising social awareness of genomic predisposition to CHD will have on population health.